Comparative analysis of early post-operative outcomes between retzius-sparing and anterior approach robotic radical prostatectomy for a single surgeon

被引：3

作者：

Tay, Li June ^{[1
]}

Makin, Robert ^{[1
]}

Saxionis, Ioannis ^{[1
]}

Dokubo, Ibi ^{[1
]}

Patel, Keval ^{[2
]}

Sivathasan, Sailantra ^{[3
]}

Smart, Sonny ^{[4
]}

Warren, Anne ^{[5
]}

Shah, Nimish ^{[1
]}

Lamb, Benjamin W. ^{[4
,6
,7
]}

机构：

[1] Cambridge Univ Hosp, Dept Urol, Cambridge, England

[2] Univ Hosp Birmingham, Dept Urol, Birmingham, England

[3] Western Gen Hosp, Dept Urol, Edinburgh, Scotland

[4] Univ Coll London Hosp NHS Trust, Dept Urol, London, England

[5] Cambridge Univ Hosp, Dept Pathol, Cambridge, England

[6] Anglia Ruskin Univ, Fac Hlth Educ Med & Social Care, Cambridge, England

[7] Barts Hlth NHS Trust, Dept Urol, London, England

来源：

JOURNAL OF CLINICAL UROLOGY | 2025年 / 18卷 / 02期

关键词：

Retzius-sparing; learning curve; training; robot-assisted radical prostatectomy; oncological control; functional outcomes;

D O I：

10.1177/20514158231156314

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: The aim of this study was to compare intraoperative and early post-operative outcomes between retzius-sparing robotic-assisted radical prostatectomy (RS-RARP) versus standard approach for RARP (S-RARP). Patients and methods: All RARPs by a single surgeon were included and divided into two groups: (1) standard approach including combined anterior-posterior approach (S-RARP); (2) retzius-sparing posterior approach (RS-RARP). Allocation was based on prostate size and location of index lesion on MRI. Initial post-operative follow-up was at 6 weeks. Results: Overall, 169 RARPs were performed between March 2018 and October 2021: S-RARP = 99 versus RS-RARP = 70. There was no significant difference in pre-operative body mass index (BMI), prostate-specific antigen (PSA), International Society of Urological Pathology (ISUP) grade group and clinical T stage. Intraoperative differences were found in blood loss (300 versus 200 mL, p = 0.008), console time (180 versus 135 minutes, p < 0.001) favouring RS-RARP, with no differences in nerve-spare or lymph node dissection. Post-operatively, no difference was found in ISUP grade, pathological T stage, positive surgical margins, number of lymph nodes sampled, readmissions or complications. Gland size in the RS group was smaller (38 versus 29 g, p = 0.001). Early (6 weeks) post-op follow-up showed a significant difference between groups for both pad-free continence (35% versus 53%, p = 0.011) and social continence (79% versus 89%, p = 0.024), but no difference for erectile function recovery (27% versus 50% of baseline) and post-op PSA levels < 0.1 ng/mL (85% versus 93%). Conclusion: Even early in the learning curve, continence recovery, operative time and blood loss were significantly better for RS-RARP than S-RARP. Margin status and PSA levels are comparable to published literature for both groups. Standardised training in RS-RARP might help to improve the uptake of this novel technique.

引用

页码：114 / 120

页数：7

共 16 条

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